Arthroscopic treatment of total knee arthroplasty complications

Abstract

The most frequent indications for arthroscopy in patients with total knee arthroplasty (TKA) are soft-tissue impingement, arthrofibrosis (knee stiffness), periprosthetic infection and removal of free bodies or cement fragments. When performing a knee arthroscopy in a patient with a symptomatic TKA, look for possible free/retained bone or cement fragments, which can be anywhere in the joint. Patellar tracking should be evaluated and soft-tissue impingement under the patella or between the femoral and tibial prosthetic components should be ruled out. Current data suggest that knee arthroscopy is an effective procedure for the treatment of some patients with symptomatic TKA. The approximate rates of therapeutic success vary according to the problem in question: 85% in soft-tissue impingement; 90% in arthrofibrosis; and 55% in periprosthetic infections. More clinical studies are needed to determine which patients with symptomatic TKA can be the best candidates for knee arthroscopy. Cite this article: EFORT Open Rev 2019;4:33-43. DOI: 10.1302/2058-5241.4.180035.

Revision Total Knee Arthroplasty: Epidemiology and Causes

“…1.1 and 1.2) followed by aseptic loosening (21.9%) (Fig. 1.3) and periprosthetic fracture (13.7%) [10][11][12][13]. Other less common causes of revision RTKA were instability (Fig.…”

Knee Arthroscopy After Prior Total Knee ArthroplastyType of Study: Narrative Review

“…General considerations when conducting arthroscopy on a prosthetic knee include alteration of native anatomic landmarks affecting portal placement; damage to implant surfaces, which can accelerate implant wear; creation of loose bodies; destabilizing a well-balanced prosthetic knee with excessive force used during the procedure; and risk of periprosthetic joint infection (PJI). 3,7,8,10,22…”

Bone loss in aseptic revision total knee arthroplasty: management and outcomes

“…There are several instances where cement should be used with caution, however, as PMMA does not provide biologic fixation and cannot restore lost bone stock [ 23 ]. Cement is also subject to fragmentation, which may lead to prosthetic loosening [ 24 ], thermal necrosis secondary to the natural exothermic reaction involved in polymerization [ 25 ], and the potential for fat embolism [ 26 ].…”